Families First Coronavirus Response

Act (FFCRA) – Guidance and Employee Leave Request Form

• About FFCRA

• Employee

Responsibilities

• Pay Rates and

Documentation

• Supervisor

Responsibilities

• Employee

Leave Request

Form

• Employee

Rights Poster

Rev. April 8, 2020

Families First Coronavirus Response Act (FFCRA) – Guidance and Employee Leave Request Form

The Families First Coronavirus Response Act (FFCRA) was signed into law March 18, 2020. The FFCRA, effective April 1, 2020 through December 31, 2020, includes two additional types of leave for employees impacted by COVID-19: Emergency Paid Sick Leave and Family and Medical Leave (EFMLA). Each type of paid leave has specific eligibilityrequirements and overall restrictions on the total amount of pay an employee may receive when taking leave.

Emergency Paid Sick Leave Act (EPSL)The Emergency Paid Sick Leave Act provides up to 80 hours of paid sick leave to eligible employees under any of six qualifying reasons related to COVID-19.

Emergency Family and Medical Leave Expansion Act (EFMLA) The Emergency Family and Medical Leave Expansion Act (EFMLA) expands the federal Family and Medical Leave Act to provide leave for eligible employees who are unable to work or telecommute as a result of having to care for the employee's child due to a COVID-19 related closure of a school or childcare center.

Both types of paid leave provisions take effect April 1, 2020, and both expire Dec. 31, 2020.

For more information on the FFCRA and new leave provisions, including frequently asked questions and the US Department of Labor’s informational poster, access the Office of Human Resources’ FFCRA webpage.

Employee Responsibilities:

Step I: Determine if you are applying for: 1. Emergency Paid Sick Leave (EPSL),2. Emergency Family Medical Leave (EFMLA), or3. Emergency Paid Sick Leave AND Emergency Family Medical Leave Note: Emergency Paid Sick Leave can be used during

the first 10 days of EFMLA to provide payment during the initial 10 days of EFMLA which is not paid.

Step II: Gather documentation to support your request. Suggested documentation is in the table below. Complete and sign the enclosed “EMPLOYEE REQUEST FOR EMERGENCY PAID SICK LEAVE (EPSL) AND/OR EXTENDED FAMILYAND MEDICAL LEAVE (EFMLA).” Obtain your supervisor or department head signature on the form.

Step III: Submit the completed form to FMLA@clemson.edu.

Step IV: Enter your paid or unpaid leave in the Kronos leave tracking system prior to the end of the pay week. Contact your supervisor if you need assistance entering leave.

NOTE: The leave provisions of the FFCRA are only for those eligible employees who cannot work, including telecommuting, as a result of COVID-19. As directed by Governor Henry McMaster in his executive orders, state agencies should first offer telecommuting opportunities to employees to the maximum extent possible and offer paid leave available to employees under the FFCRA only if telecommuting opportunities have been exhausted. An employee cannot refuse work, unless the grounds for the request prevent the employee from working, including telecommuting. As an example, an employee may only take paid leave due to “Federal, State, or local quarantine or isolation orders” (the first of the six qualifying reasons) if being subject to one of these orders prevents the employee from working. According to the Department of Labor, an employee may not take paid sick leave, if:

• the employer has work for the employee to perform,

• the employer permits the employee to perform that work from a remote location (e.g., where the employee isself-quarantining), and

• there are no extenuating circumstances that prevent the employee from performing work.Therefore, an employee may not take FFCRA leave simply because he or she prefers it to the telecommuting opportunities offered by the employer. Instead, an employee may only take FFCRA leave if one of the qualifying reasons for leave prevents the employee from performing the work offered.

FFCRA Instructions page 1 of 2

Rev. April 8, 2020

FFCRA LEAVE REASON AND PAY RATE SUGGESTED DOCUMENTATION

1. The employee is subject to a Federal, State, orlocal quarantine or isolation orders related toCOVID–19. (Leave provided at regular rate of payup to $511.00 per day.)

The name of the government entity that issued the quarantine or isolation order to which the employee is subject and confirmation that the employee is not required to physicallyreport to work, that all telecommuting options have been explored and there is no option for telecommuting.

2. The employee has been advised by a health careprovider to self-quarantine due to concernsrelated to COVID–19. (Leave provided at regularrate of pay up to $511.00 per day.)

The name of the healthcare provider who advised self-quarantine for COVID-19 related reasons.

3. The employee is experiencing symptoms ofCOVID–19 and seeking a medical diagnosis.(Leave provided at regular rate of pay up to$511.00 per day.)

Confirmation of a doctor’s appointment or a written statement from the employee that the employee is experiencing applicable symptoms and describing the affirmative steps the employee has taken to obtain a medical diagnosis. A statement that no suitable arrangements can be made for the employee to telecommute.

4. The employee is caring for an individual who issubject to an order as described in subparagraph1 or has been advised as described in reason 2.(Leave provided at two-thirds the employees’regular rate of pay up to $200.00 per day.)

(1) The government entity that issued the quarantine or isolationorder to which the individual is subject or (2) the name of thehealthcare provider who advised the individual to self-quarantine, depending on the precise reason for the request. Astatement that no suitable arrangements can be made for theemployee to telecommute.

5. The employee is caring for a son or daughter ofsuch employee if the school or place of care of theson or daughter has been closed, or the childcareprovider of such son or daughter is unavailable,due to COVID–19 precautions. (Leave provided attwo-thirds the employees’ regular rate of pay upto $200.00 per day.)

(1) The name of the child being cared for; (2) the name of theschool, place of care, or child care provider that closed or becameunavailable due to COVID-19 reasons; and (3) a statementrepresenting that no other suitable person is available to care forthe child during the period of requested leave and that no suitablearrangements can be made for the employee to telecommute.

6. The employee is experiencing any othersubstantially similar condition specified by theSecretary of Health and Human Services inconsultation with the Secretary of the Treasuryand the Secretary of Labor. (Leave provided attwo-thirds the employees’ regular rate of pay upto $200.00 per day.)

If leave is being taken for this reason, please contact Ask-HR for additional information.

Supervisor Responsibilities:

Step I: If an employee requests this type of leave, discuss telecommuting options and flexible work arrangements to help the employee decide if leave should be taken continuously or intermittently, or if other telecommuting options can be arranged. Per the Governor’s executive orders, state agencies should first offer telecommuting opportunities to employees to the maximum extent possible and offer paid leave available to employees under the FFCRA only if telecommuting opportunities have been exhausted. If intermittent leave is a workable solution, establish and document the intermittent/flexible work schedule. If work is available and the employee declines the work opportunities presented, or if no telecommuting opportunities are available, please contact Ask-HR before signing this form.

Step II: Sign the form on the Supervisor Signature line and return the signed form to the employee for submission.

Questions? If you have any questions regarding the Families First Coronavirus Response Act, please submit an inquiry to Ask-HR.

FFCRA Instructions page 2 of 2

Form Page 1 of 2 CONFIDENTIAL Rev. April 8, 2020

EMPLOYEE REQUEST FOR EMERGENCY PAID SICK LEAVE (EPSL) AND/OR EMERGENCY FAMILY ANDMEDICAL LEAVE (EFMLA)

Employees requesting Emergency Paid Sick Leave (EPSL) and/or Emergency FMLA (EFMLA) pursuant to the Families First CoronavirusResponse Act (FFCRA) must complete this form. Before completing this form, please review the information on the Office of Human Resources’ FFCRA webpage. When requesting leave, provide as much advance notice as is reasonably practicable. Submit this request form to your supervisor or department head for review before the leave is to commence.

Employee Name: ______________________________ EMPL ID: ___________________ Hire date: ______________________

Employee Mailing Address: ____________________________________ Clemson Email: _________________________________

Home Phone Number: ____________________________ Cell Phone Number: _________________________________________

Supervisor Name: ____________________________________________ Department: ___________________________________

This is a (choose one): ☐ New request for leave ☐ Request for an extension of leave

I will need (choose one): ☐ Full-time (continuous) ☐ Intermittent (sporadic) *

* Briefly describe the nature of your intermittent leave, including anticipated number of leave hours per day: _____________________________________________________________________________________________________

Begin Date of Leave: ___________________________ Expected Return to Work Date: _____________________________

I. Emergency Paid Sick Leave (EPSL): Provides up to 80 hours of paid sick leave for eligible employees.

Below are the conditions under which you may qualify for Emergency Paid Sick Leave. Please select all that apply.

☐ 1. You are subject to a Federal, State, or local quarantine or isolation order related to COVID-19.

☐ 2. You have been advised by a healthcare provider to self-quarantine related to COVID-19.

☐ 3. You are experiencing COVID-19 symptoms and are seeking medical diagnosis.

☐ 4. You are caring for an individual subject to a Federal, State, or local quarantine or isolation order related to COVID-19 OR youare caring for an individual who has been advised by a healthcare provider to self-quarantine related to COVID-19.

☐ 5. You are caring for a child whose school or place of care is closed (or childcare provider is unavailable) for reasons related toCOVID-19.

☐ 6. You are experiencing any other substantially-similar condition specified by the Secretary of Health and Human Services, inconsultation with the Secretaries of Labor and Treasury.

II. Extended Family Medical Leave Act (EFMLA): Expands the Federal Family and Medical Leave Act to provide leavefor employees who are unable to work, including work-from-home, as a result of having to care for a son or daughterdue to a COVID-19 related closure of a school or childcare center.Note: You may be eligible for both Emergency Paid Sick Leave (EPSL) and EFMLA.

Are you requesting benefits under the Family and Medical Leave Act (FMLA) because you are caring for a son or daughter whose school or place of care is closed (or childcare provider is unavailable) for reasons related to COVID-19?

(Choose one) ☐ Yes ☐ No

III. Supervisor Acknowledgement

Supervisor Signature: ________________________________________________ Date: _______________________

Note to Supervisor: Your signature serves as an acknowledgment of the request and indicates your certification that no telecommuting or flexible schedule arrangements could be made for the employee to continue work.

Form Page 2 of 2 CONFIDENTIAL Rev. April 8, 2020

IV. Use of Accrued Leave Decision

Employee Name: ____________________________________________ Employee ID Number: ___________________________

The pay provided under the Emergency Paid Sick Leave (EPSL) Act and EFMLA may be less than an employee’s normal rate of paybecause of limitations on the pay rate which will be paid under these leave types or daily or aggregate limits. In this situation, employees may use available accrued leave (i.e. sick leave, annual leave and compensatory time) to augment leave taken pursuant to the Emergency Paid Sick Leave (EPSL) Act and EFMLA to increase the pay received up to their regular salary rate. Leave can only betaken which is available to the employee as of the date the Emergency Paid Sick Leave (EPSL) or EFMLA leave is taken.

Would you like to use accrued leave to supplement leave taken pursuant to the Emergency Paid Sick Leave Act or the Emergency Family and Medical Leave Expansion Act?

Yes – *Please answer the questions below.

No – If you answer No, you do not need to address the remaining questions. You may skip to Section V. below.

*If you answered yes to the question above, you must indicate which leave types will be used.

It is recommended that leave be applied in the following order in the amount necessary to bring the employee’s pay up to their regular rate of pay until that leave type is exhausted and then moving on to the next leave type.

1. Sick Leave (including advanced sick leave)

2. Compensatory Time (including holiday compensatory time)

3. Annual Leave

Would you like your leave applied in this way?

Yes – If you answer yes, you are finished. You may skip to Section V.

No – If you answer no, please indicate the amount and type of leave you would like to use below.

If you answered no to the question above, you must indicate the amount and type of leave you would like to take. You may not take leave beyond the amount which results in your regular rate of pay.

V. Employee Certification and Signature

In order to request leave under FFCRA, you must be unable to work or telework because of a COVID-19 qualifying reason. Please check “yes” to confirm that you are unable to work or telework due to a COVID-19 qualifying reason. Yes No

I agree to return to work on ________________________. If circumstances change such that I will not be able to return to work on that date, I agree to inform my supervisor by submitting a new approval request form. I certify that the above information is accurate and complete.

Employee Signature: ________________________________________________ Date: _______________________

Submit your completed and signed two-page form to FMLA@clemson.edu.

EMPLOYEE RIGHTSPAID SICK LEAVE AND EXPANDED FAMILY AND MEDICAL LEAVE UNDER THE FAMILIES FIRST CORONAVIRUS RESPONSE ACT

WAGE AND HOUR DIVISIONUNITED STATES DEPARTMENT OF LABOR

WH1422 REV 03/20

For additional information or to file a complaint:1-866-487-9243

TTY: 1-877-889-5627dol.gov/agencies/whd

1. is subject to a Federal, State, or local quarantine or isolation order related to COVID-19;

2. has been advised by a health care provider to self-quarantine related to COVID-19;

3. is experiencing COVID-19 symptoms and is seekinga medical diagnosis;

4. is caring for an individual subject to an order described in (1) or self-quarantine as described in (2);

► ENFORCEMENTThe U.S. Department of Labor’s Wage and Hour Division (WHD) has the authority to investigate and enforce compliancewith the FFCRA. Employers may not discharge, discipline, or otherwise discriminate against any employee wholawfully takes paid sick leave or expanded family and medical leave under the FFCRA, files a complaint, or institutes aproceeding under or related to this Act. Employers in violation of the provisions of the FFCRA will be subject to penaltiesand enforcement by WHD.

5. is caring for his or her child whose school orplace of care is closed (or child care provider isunavailable) due to COVID-19 related reasons; or

6. is experiencing any other substantially-similarcondition specified by the U.S. Department ofHealth and Human Services.

The Families First Coronavirus Response Act (FFCRA or Act) requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID-19. These provisions will apply from April 1, 2020 through December 31, 2020.

► PAID LEAVE ENTITLEMENTSGenerally, employers covered under the Act must provide employees:Up to two weeks (80 hours, or a part-time employee’s two-week equivalent) of paid sick leave based on the higher of their regular rate of pay, or the applicable state or Federal minimum wage, paid at:

• 100% for qualifying reasons #1-3 below, up to $511 daily and $5,110 total;• 2/3 for qualifying reasons #4 and 6 below, up to $200 daily and $2,000 total; and• Up to 12 weeks of paid sick leave and expanded family and medical leave paid at 2/3 for qualifying reason #5

below for up to $200 daily and $12,000 total.A part-time employee is eligible for leave for the number of hours that the employee is normally scheduled to work over that period.

► ELIGIBLE EMPLOYEESIn general, employees of private sector employers with fewer than 500 employees, and certain public sectoremployers, are eligible for up to two weeks of fully or partially paid sick leave for COVID-19 related reasons (see below). Employees who have been employed for at least 30 days prior to their leave request may be eligible for up to anadditional 10 weeks of partially paid expanded family and medical leave for reason #5 below.

► QUALIFYING REASONS FOR LEAVE RELATED TO COVID-19An employee is entitled to take leave related to COVID-19 if the employee is unable to work, including unable totelework, because the employee: